Doctor Strange: A Medical Review

A review of the medical scenes in Doctor Strange. There will be spoilers, so be warned! I. DR. STRANGE’S INJURY The heart is surrounded by a tough fibrous membrane called the pericardial sac. This membrane fits tightly around the heart, with just a few milliliters of fluid in between the two. If extra fluid gets into the pericardial sac, say blood from a stabbing injury, then a situation known as “tamponade” occurs. Because the pericardium is too tough to expand, all the extra fluid instead pushes down on and compresses the heart. Compressed, the heart is unable to expand, or even beat, leading rapidly to an emergency situation. Clinically, tamponade presents as acute heart failure with Beck’s triad1: distended jugular veins, muffled heart sounds, and pulsus paradoxus (a large drop in blood pressure during inspiration). The treatment for tamponade is to drain the extra fluid out of the pericardial sac, but it’s a tricky procedure because the heart is hidden behind the rib cage, and even in tamponade situations, the pericardial sac is not separated from the heart by much. The doctor needs to get the needle into the pericardium and drain the fluid without damaging the heart in the process. A needle can be slowly advance through the chest under fluoroscopic (i.e. x-ray) guidance, but this takes precious time to set up and not every hospital has access to the equipment. Cardiac tamponade is a life-threatening situation and time is of the essence. Emerge...
Source: Polite Dissent - Category: Primary Care Authors: Tags: newtag Source Type: blogs